International Journal of Technology Assessment in Health Care

General Essays

Cost Comparison of Parenteral Estrogen and Conventional Hormonal Treatment in Patients With Prostatic Cancer

Peter Henrikssona1 and Reinhard Stegea2

a1 Huddinge University Hospital and Karolinska Institute

a2 Huddinge University Hospital

Abstract

The present study compares the cost of antitumor therapy and adverse cardiovascular effects during the first year of treatment with oral estrogens, nonoral estrogens, or surgical castration in patients with prostatic cancer. We found a much higher cost for patients treated with orchidectomy and oral estrogens than for patients treated with nonoral estrogens. Twenty-five percent of the patients treated with oral estrogen suffered cardiovascular complications, compared to none of the patients treated by orchidectomy or nonoral estrogens. The initial cost of orchidectomy as compared to nonoral estrogen treatment was shown not to be balanced within the expected survival time of patients with advanced prostatic cancer. Furthermore, surgical castration causes psychological trauma to the patient. We recommend parenteral estrogen therapy as a low-cost therapeutic regimen in patients with prostatic cancer.